There is a total of 226 healthcare undergraduates and 359 SS students who participated in the program from 2015 to 2018. Response rate was 80.1% and 62.4% amongst the healthcare undergraduates and SS students respectively. Table 2 describes the profile of the participants.
Table 2
Demographic profile of students who participated in the TriGen Programme from 2014–2017.
| Healthcare undergraduates | Secondary school students |
Total number of participants | 226 | 359 |
Number of respondents | 181 | 224 |
Response rate | 80.1% | 62.4% |
Median Age (Range) | 21 (18–41) | 15 (13–17) |
Gender |
Male | 68 (37.6%) | 79 (35.3%) |
Female | 113 (62.4%) | 145 (64.7%) |
Faculty/School |
| Medicine: 57 (31.5%) | West Spring Secondary School: 80 (35.7%) |
| Nursing: 23 (12.7%) | Yishun Secondary School: 112 (50%) |
| Pharmacy: 76 (42.0%) | Orchid Park Secondary School: 25 (11.2%) |
| Social Work: 20 (11.0%) | Chung Cheng High School: 1 (0.4%) |
| Physiotherapy and Occupational Therapy: 5 (2.8%) | Anglo-Chinese School (Independent): 3 (1.3%) |
| | Eunoia Junior College: 3 (1.3%) |
Year of study |
Year 1 | 72 (39.8%) | - |
Year 2 | 41 (22.7%) | 37 (16.5%) |
Year 3 | 52 (28.7%) | 178 (79.5%) |
Year 4 | 14 (7.7%) | 3 (1.3%) |
Year 5 | 2 (1.7%) | 6 (2.7%) |
Living with grandparents |
Yes | 25 (13.8%) | 49 (21.9%) |
No | 156 (86.2%) | 175 (78.1%) |
Involved in volunteer work with the older person |
Yes | 131 (72.4%) | 123 (54.9%) |
No | 50 (27.6%) | 101 (45.1%) |
Hours spent on CIP |
Excluding training | | 410 min |
Inclusive of training | | 480 min |
Previous IPE activities |
| Yes: 117 (64.6%) | |
| No: 64 (35.4%) | |
Kogan’s Old People score
Healthcare undergraduates
There was a statistically significant increase in KOP score pre- and post-intervention for healthcare undergraduates with a mean increase of 12.8 (95% CI: 9.46–16.2, p < 0.001). (Table 3) This increase was found in all groups of undergraduates. All subgroups analysed had a statistically significant increase in KOP score pre- and post-intervention. There was a statistically significant difference in pre-intervention KOP score between those who stay with their grandparents and those who do not as determined by one-way ANOVA (F (1, 206) = 4.778, p = 0.03). A Tukey post hoc test revealed that undergraduates who stay with their grandparents have higher pre-intervention KOP scores (i.e. have less ageist attitudes) (mean score 138.3, 95% CI: 132.5–144.2) as compared to those who do not (mean score 132.1, 95% CI: 128.9–135.3). There was no statistically significant difference for pre-intervention KOP found for different genders (male versus female), seniority (preclinical versus clinical), previous or current volunteer work involving the older persons.
Table 3
KOP score in university healthcare undergraduates.
Group | No. | Pre-Intervention Score (mean, 95%CI) | P-value (comparison between groups for pre-intervention score) | Post-Intervention Score (mean, 95%CI) | Mean Difference | P-value | Comparison between groups |
All University Students | 172 | 133.0 (130.1–135.9) | | 145.7 (143.3–148.1) | 12.8 (9.4–16.2) | < 0.0001 | |
Gender | | | 0.26 | | | | 0.075 |
Male | 64 | 135.5 (131.2–139.8) | | 144.3 (139.6–148.9) | 8.8 (3.6–14.0) | 0.001 | |
Female | 108 | 131.5 (127.6–135.3) | | 146.6 (143.9–149.3) | 15.1 (10.7–19.6) | < 0.0001 | |
Year of Study | | | 0.15 | | | | 0.43 |
Year 1 and 2 | 108 | 134.8 (130.6–138.9) | | 146.5 (143.3–149.7) | 11.7 (7.1–16.4) | < 0.0001 | |
Year 3 to 5 | 64 | 130.0 (126.7–133.2) | | 144.5 (140.9–148.1) | 14.5 (9.7–19.3) | < 0.0001 | |
Faculty | | | 0.78 | | | | 0.53 |
Medical | 57 | 132.8 (126.1–139.5) | | 148.9 (144.9–153.0) | 16.1 (8.4–23.9) | < 0.0001 | |
Nursing | 23 | 134.2 (128.8–139.7) | | 147.7 (142.9–152.4) | 13.4 (8.3–18.6) | < 0.0001 | |
Pharmacy | 68 | 132.5 (128.5–136.6) | | 141.7 (137.3–146.1) | 9.18 (4.00–14.36) | 0.001 | |
Social Work | 19 | 131.8 (125.5–138.1) | | 146.6 (141.1–152.1) | 14.79 (7.63–21.95) | < 0.0001 | |
Therapist | 5 | 139.4 (133.0–145.8) | | 151.6 (142.7–160.5) | 12.2 (3.0–21.4) | 0.021 | |
Living with grandparents | | | 0.032 | | | | 0.65 |
Yes | 24 | 138.3 (132.5–144.2) | | 149.1 (143.2–155.1) | 10.8 (2.73–18.9) | 0.011 | |
No | 148 | 132.1 (128.9 -135.3) | | 145.2 (142.5–147.8) | 13.1 (9.3–16.8) | < 0.0001 | |
Have you volunteered in an old person facility? | | | 0.97 | | | | 0.13 |
Yes | 127 | 132.9 (129.2–136.5) | | 147.2 (144.2–150.1) | 14.3 (9.9–18.7) | < 0.0001 | |
No | 45 | 133.2 (129.0–137.4) | | 141.6 (137.7–145.6) | 8.4 (4.5–12.3) | < 0.0001 | |
Pre-intervention Kogan’s scores is weakly positively associated with post-intervention Kogan’s scores (r = 0.177, p = 0.020) and moderately negatively associated with the difference in Kogan’s scores (r=-0.724, p < 0.001).
Secondary School Students
There was a statistically significant increase in KOP score pre- and post-intervention for SS students with a mean increase of 8.3 (95% CI: 6.2–10.3, p < 0.001). (Table 4) All subgroups analysed had a statistically significant increase in KOP score pre- and post-intervention. There was no statistically significant difference for pre-intervention KOP found between the different genders (male versus female), secondary schools, seniority (lower secondary versus upper secondary), whether they are living with their grandparents or having previous volunteering experience in an old person facility.
Table 4
KOP score in secondary school students.
Group | No. | Pre-Intervention Score (mean, 95%CI) | P-value (comparison between groups for pre-intervention score) | Post-Intervention Score (mean, 95%CI) | Mean Difference | P-value | Comparison between groups |
All secondary school | 224 | 127.4 (125.6–129.2) | | 135.7 (134.1–137.3) | 8.3 (6.2–10.3) | < 0.001 | |
Gender | | | 0.27 | | | | 0.55 |
Male | 79 | 128.78 (125.21–132.36) | | 136.19 (133.68–138.71) | 7.41 (3.46–11.35) | < 0.001 | |
Female | 145 | 126.67 (14.66–128.67) | | 135.42 (133.07–137.77) | 8.75 (6.43–11.07) | < 0.001 | |
Age | | | 0.12 | | | | 0.69 |
Younger (Age 13–14) | 63 | 125.16 (122.69–127.63) | | 134.05 (130.47–137.63) | 8.89 (5.18–12.59) | < 0.001 | |
Older (Age 15–17) | 161 | 128.30 (125.98–130.61) | | 136.34 (134.33–138.34) | 8.04 (5.59–10.48) | < 0.001 | |
School | | | 0.43 | | | | 0.54 |
School 1 (Westspring) | 80 | 127.48 (124.31–130.64) | | 137.84 (135.24–140.44) | 10.36 (6.83–13.90) | < 0.001 | |
School 2 (Yishun Sec) | 112 | 126.30 (123.83–128.76) | | 133.82 (131.11–136.53) | 7.53 (4.49–10.57) | < 0.001 | |
Others | 32 | 131.10 (126.47–135.91) | | 136.88 (132.71–141.04) | 5.69 (2.01–9.36) | 0.004 | |
Living with grandparents | | | 0.45 | | | | 0.84 |
Yes | 49 | 126.12 (122.70–129.54) | | 133.96 (131.02–136.90) | 7.84 (4.36–11.32) | < 0.001 | |
No | 175 | 127.78 (125.69–129.86) | | 136.18 (134.08–138.27) | 8.40 (5.98–10.82) | < 0.001 | |
Have you volunteered in an old person facility? | | | 0.37 | | | | 0.26 |
Yes | 123 | 128.15 (125.94–130.37) | | 135.41 (132.79–138.02) | 7.25 (4.56–9.94) | < 0.001 | |
No | 101 | 126.52 (123.59–129.44) | | 136.04 (133.78–138.30) | 9.52 (6.40–12.65) | < 0.001 | |
Do you have any siblings? | | | 0.56 | | | | 0.36 |
Yes | 185 | 127.17 (125.18–129.17) | | 135.89 (133.98–137.81) | 8.72 (6.41–11.03) | < 0.001 | |
No | 39 | 128.56 (124.52–132.61) | | 134.74 (130.31–139.18) | 6.18 (2.11–10.25) | 0.004 | |
Number of hours spent on home visits is weakly positively associated with difference in KOP scores (r = 0.234, p < 0.001). Pre-intervention Kogan’s scores is weakly positively associated with post-intervention Kogan’s scores (r = 0.333, p < 0.001) and moderately negatively associated with the difference in Kogan’s scores (r = -0.598, p < 0.001).
The baseline KOP score of the healthcare undergraduates is significantly higher than that of the secondary school students by (mean = 6.8, 95% CI: 3.7 to 9.9, p < 0.001), and the increase in KOP score for healthcare undergraduates was also significantly more than that of the secondary school students (mean = 4.6, 95% CI: 0.7 to 8.4, p = 0.022).
Palmore’s Facts of Aging Quiz
Healthcare undergraduates
The average pre- and post-intervention Palmore’s FAQ score is 15.8 and 16.0 respectively, but there was no significant difference in Palmore's FAQ score (p = 0.112). (Table 5)
Table 5
Palmore score in healthcare undergraduate
Group | No. | Pre-Intervention Score (mean, 95%CI) | P-value (comparison between groups for pre-intervention score) | Post-Intervention Score (mean, 95%CI) | Mean Difference | P-value | Comparison between groups |
All university students | 127 | 15.7 (15.1–16.2) | | 16.2 (15.7–16.6) | 0.49 (− 0.095–1.07) | 0.10 | |
Gender | | | 0.050 | | | | 0.43 |
Male | 48 | 16.3 (15.5–17.1) | | 16.5 (15.9–17.1) | 0.19 (− 0.61–0.98) | 0.64 | |
Female | 79 | 15.3 (14.5–16.1) | | 15.9 (15.4–16.5) | 0.67 (− 0.14–1.49) | 0.11 | |
Year of Study | | | 0.13 | | | | 0.087 |
Year 1 and 2 | 93 | 16.0 (15.4–16.7) | | 16.2 (15.8–16.7) | 0.18 (− 0.48–0.85) | 0.59 | |
Year 3 to 5 | 34 | 14.7 (13.5–15.8) | | 16.0 (15.1–16.8) | 1.32 (0.11–2.54) | 0.034 | |
Faculty | | | 0.20 | | | | 0.14 |
Medical | 44 | 16.0 (14.9–17.1) | | 16.8 (16.2–17.4) | 0.77 (-0.33–1.87) | 0.16 | |
Nursing | 14 | 13.8 (11.2–16.3) | | 15.5 (14.4–16.6) | 1.71 (− 1.05–4.48) | 0.20 | |
Pharmacy | 51 | 16.1 (15.3–16.8) | | 15.7 (15.0–16.4) | − 0.37 (− 1.11–0.36) | 0.31 | |
Social Work | 13 | 15.2 (13.7–16.7) | | 16.7 (15.4–18.0) | 1.54 (− 0.16–3.24) | 0.072 | |
Therapist | 5 | 15.0 (13.6–16.4) | | 15.6 (13.9–17.3) | 0.60 (− 1.98–3.18) | 0.553 | |
Living with grandparents | | | 0.14 | | | | 0.55 |
Yes | 18 | 16.3 (15.3–17.2) | | 16.3 (15.2–17.5) | 0.056 (− 1.12–1.23) | 0.922 | |
No | 109 | 15.6 (14.9–16.2) | | 16.1 (15.7–16.6) | 0.56 (− 0.097–1.22) | 0.094 | |
Have you volunteered in an old person facility? | | | 0.59 | | | | 0.26 |
Yes | 95 | 15.8 (15.1–16.5) | | 16.1 (15.7–16.6) | 0.30 (− 0.43–1.02) | 0.42 | |
No | 32 | 15.1 (14.1–16.2) | | 16.2 (15.3–17.1) | 1.06 (0.17–1.96) | 0.021 | |
There is a weak positive correlation between: i) baseline Kogan's and baseline Palmore's scores (ρ = 0.183, p = 0.008); ii) post-intervention Kogan's and post-intervention Palmore's scores (ρ = 0.373, p < 0.001); and iii) change in Kogan’s and change in Palmore’s scores (ρ = 0.266, p < 0.001).
Secondary School Students
There was a statistically significant increase in Palmore FAQ score pre- and post-intervention for SS students with a mean increase of 0.8 (95% CI: 0.3–1.4, p = 0.005). (Table 6) Female students, older students, those who do not live with their grandparents, those who had never volunteered in an old person facility and those who have siblings were associated with a statistically significant increase in Palmore FAQ score. There was no statistically significant difference in pre-intervention Palmore FAQ score between the different genders (male versus female), secondary schools, seniority (lower secondary versus upper secondary), whether they are living with their grandparents or having previous volunteering experience in an old person facility.
Table 6
Palmore score in secondary school students
Group | No. | Pre-Intervention Score (mean, 95%CI) | P-value (comparison between groups for pre-intervention score) | Post-Intervention Score (mean, 95%CI) | Mean Difference | P-value | Comparison between groups for mean difference |
All secondary school | 162 | 13.3 (12.9–13.8) | | 14.2 (13.6–14.7) | 0.81 (0.25–1.38) | 0.005 | |
Gender | | | 0.061 | | | | 0.57 |
Male | 64 | 13.89 (13.17–14.61) | | 14.53 (13.79–15.28) | 0.64 (-0.12–1.40) | 0.097 | |
Female | 98 | 12.99 (12.38–13.60) | | 13.92 (13.13–14.71) | 0.93 (0.13–1.73) | 0.023 | |
Age | | | 0.15 | | | | 0.21 |
Younger (Age 13–14) | 32 | 14.03 (12.89–15.17) | | 14.16 (12.83–15.48) | 0.13 (-1.18–1.43) | 0.85 | |
Older (Age 15–17) | 130 | 13.18 (12.67–13.69) | | 14.16 (13.54–14.78) | 0.98 (0.36–1.61) | 0.002 | |
School | | | 0.23 | | | | 0.15 |
School 1 (Westspring) | 52 | 13.77 (12.92–14.62) | | 14.08 (13.18–14.97) | 0.31 (− 0.66–1.28) | 0.53 | |
School 2 (Yishun Sec) | 81 | 12.90 (12.23–13.57) | | 13.90 (13.09–14.71) | 1.00 (0.23–1.77) | 0.011 | |
Others | 29 | 13.82 (12.82–14.84) | | 15.03 (13.57–16.50) | 1.21 (-0.44–2.85) | 0.14 | |
Living with grandparents | | | 0.75 | | | | 0.22 |
Yes | 37 | 13.49 (12.66–14.31) | | 13.68 (12.52–14.84) | 0.19 (− 0.93–1.31) | 0.73 | |
No | 125 | 13.30 (12.75–13.86) | | 14.30 (13.66–14.95) | 1.00 (0.35–1.65) | 0.003 | |
Have you volunteered in an old person facility? | | | 0.66 | | | | 0.49 |
Yes | 88 | 13.25 (12.64–13.86) | | 13.86 (13.10–14.63) | 0.61 (-0.11–1.33) | 0.093 | |
No | 74 | 13.56 (12.73–14.19) | | 14.51 (13.69–15.34) | 1.05 (0.15–1.96) | 0.023 | |
Do you have any siblings? | | | 0.084 | | | | 0.58 |
Yes | 128 | 13.56 (13.02–14.09) | | 14.28 (13.66–14.90) | 0.73 (0.11–1.34) | 0.021 | |
No | 34 | 12.56 (11.67–13.45) | | 13.71 (12.41–15.00) | 1.15 (-0.27- 2.57) | 0.11 | |
There is no correlation between time spent visiting the elderly and change in Palmore's FAQ scores (ρ = 0.136, p = 0.084). There is a moderate positive correlation between: i) baseline Kogan's and baseline Palmore's scores (ρ = 0.437, p < 0.001); and ii) post-intervention Kogan's and post-intervention Palmore's scores (ρ = 0.472, p < 0.001). There is a weak positive correlation between the change in Kogan's and the change in Palmore's scores (ρ = 0.349, p < 0.001).
Healthcare undergraduates had a significantly higher baseline (2.5, 95% CI: 1.8 to 3.1, p < 0.001) and post-intervention (1.8, 95% CI: 1.1 to 2.5, p < 0.001) Palmore’s FAQ score than SS students. However, the healthcare undergraduates did not have a significant difference in change in Palmore’s FAQ score compared to the SS students (-0.3, 95% CI: -1.1 to 0.5, p = 0.412).
Fund for improving postsecondary education survey
Healthcare undergraduates
Most healthcare undergraduates felt that TriGen was beneficial across all nine FIPSE domains. (Table 7) 90–100% of students reported learning in all 9 domains except for ability to make clinical diagnosis (81.6%) and apply what they have learnt in the training sessions to the home visits (80.1%).
Table 7
FIPSE in Healthcare Undergraduates
Domains of learning—“I feel that TriGen has helped me” | Total no. (%), n = 196 | Male students, no. (%), n = 68 | Female students, no.(%), n = 122 | Males versus females | Year 1 and 2, no. (%), n = 119 | Year 3 and above, no. (%), n = 71 | Pre-clinical versus Clinical |
Pearson Chi-Square | Unadjusted odds ratio (OR) (95% confidence interval) | P value | Pearson Chi-Square | Unadjusted odds ratio (OR) (95% confidence interval) | P value |
Leadership Skills |
Feel responsible for others in the Community | 191 (97.4) | 65 (95.6) | 120 (98.4) | 1.31 | 0.361 (0.059–2.22) | 0.25 | 116 (97.5) | 69 (97.2) | 0.015 | 1.12 (0.183–6.88) | 0.90 |
Improve my leadership skills | 188 (95.9) | 63 (92.6) | 119 (97.5) | 2.59 | 0.318 (0.074–1.37) | 0.11 | 115 (96.6) | 67 (94.4) | 0.569 | 1.72 (0.416–7.09) | 0.45 |
Communication Skills |
Participate in community affairs | 186 (94.9) | 61 (89.7) | 119 (97.5) | 5.38 | 0.22 (0.055–0.88) | 0.020+ | 112 (94.1) | 68 (95.8) | 0.245 | 0.706 (0.177–2.822) | 0.62 |
Develop communication, listening and negotiation skills | 194 (99.0) | 67 (98.5) | 121 (99.2) | 0.178 | 0.554 (0.034–9.00) | 0.67 | 119 (100) | 69 (97.2) | 3.39 | 1.03 (0.989–1.07) | 0.066 |
Teamwork |
Think of others | 192 (98.0) | 65 (95.6) | 121 (99.2) | 2.734 | 0.179 (0.018–1.76) | 0.098 | 117 (98.3) | 69 (97.2) | 0.279 | 1.696 (0.234–12.31) | 0.60 |
Appreciate teamwork and cooperation among peers | 194 (99.0) | 67 (98.5) | 121 (99.2) | 0.178 | 0.554 (0.034–9.00) | 0.67 | 118 (99.2) | 70 (98.6) | 0.138 | 1.69 (0.104–27.4) | 0.71 |
Be tolerant of different people | 194 (99.0) | 67 (98.5) | 121 (99.2) | 0.178 | 0.554 (0.034–9.00) | 0.67 | 118 (99.2) | 70 (98.6) | 0.138 | 1.69 (0.104–27.4) | 0.71 |
Respect different opinions | 194 (99.0) | 67 (98.5) | 121 (99.2) | 0.178 | 0.554 (0.034–9.00) | 0.67 | 119 (100) | 69 (97.2) | 3.39 | 1.03 (0.989–1.07) | 0.066 |
Compromise | 189 (96.4) | 64 (94.1) | 119 (97.5) | 1.44 | 0.403 (0.088–1.86) | 0.23 | 115 (96.6) | 68 (95.8) | 0.094 | 1.29 (0.276–5.84) | 0.76 |
Comprehend the moral and ethical issues in health care | 183 (93.4) | 63 (92.6) | 114 (93.4) | 0.043 | 0.884 (0.277–2.82) | 0.84 | 107 (89.9) | 70 (98.6) | 5.25 | 0.127 (0.016–1.00) | 0.022* |
Ability to see consequences |
Think about the future | 187 (95.4) | 62 (91.2) | 119 (97.5) | 3.92 | 0.261 (0.063–1.08) | 0.048 | 114 (95.8) | 67 (94.4) | 0.202 | 1.36 (0.353–5.25) | 0.65 |
Critical thinking skills |
Think critically | 186 (94.9) | 62 (91.2) | 118 (96.7) | 2.69 | 0.350 (0.095–1.29) | 0.10 | 114 (95.8) | 66 (93.0) | 0.72 | 1.73 (0.482–6.19) | 0.40 |
Ability to identify social issues |
Identify social issues and concerns | 192 (98.0) | 66 (97.1) | 120 (98.4) | 0.359 | 0.55 (0.076–4.00) | 0.55 | 116 (97.5) | 70 (98.6) | 0.267 | 0.552 (0.056–5.41) | 0.61 |
Action skills |
Take action | 186 (94.9)_ | 61 (89.7) | 119 (97.5) | 5.38 | 0.22 (0.055–0.88) | 0.020+ | 113 (95.0) | 67 (94.4) | 0.031 | 1.12 (0.306–4.13) | 0.86 |
Build confidence & take on new responsibilities | 191 (97.4) | 64 (94.1) | 121 (99.2) | 4.37 | 0.132 (0.014–1.21) | 0.037 | 117 (98.3) | 68 (95.8) | 1.12 | 2.58 (0.421–15.8) | 0.29 |
Gaining of knowledge |
Appreciate and identify gaps or deficiencies in the healthcare system | 185 (94.4) | 61 (89.7) | 118 (96.7) | 3.94 | 0.295 (0.083–1.05) | 0.047 | 111 (93.3) | 68 (95.8) | 0.508 | 0.612 (0.157–2.39) | 0.48 |
Appreciate my own health, living condition | 192 (98.0) | 66 (97.1) | 120 (98.4) | 0.359 | 0.550 (0.076–4.00) | 0.55 | 117 (98.3) | 69 (97.2) | 0.279 | 1.70 (0.234–12.3) | 0.60 |
Improve my general knowledge about healthcare | 180 (91.8) | 61 (89.7) | 113 (92.6) | 0.482 | 0.694 (0.246–2.00) | 0.49 | 108 (90.8) | 66 (93.0) | 0.279 | 0.744 (0.247–2.24) | 0.60 |
Enhance my understanding of the use of public health measures in resource poor setting | 189 (96.4) | 64 (94.1) | 119 (97.5) | 1.44 | 0.40 (0.088–1.86) | 0.23 | 114 (95.8) | 69 (97.2) | 0.24 | 0.661 (0.125–3.50) | 0.62 |
Application of knowledge |
Improve my clinical diagnostic skills | 160 (81.6) | 54 (79.4) | 100 (82.0) | 0.186 | 0.849 (0.402–1.79) | 0.67 | 91 (76.5) | 63 (88.7) | 4.35 | 0.413 (0.177–0.964) | 0.037* |
Apply what I learnt in the training sessions (the one organized before the start of the home visits) | 157 (80.1) | 57 (83.8) | 94 (77.0) | 1.23 | 1.54 (0.714–3.34) | 0.27 | 87 (73.1) | 64 (90.1) | 7.91 | 0.297 (0.123–0.716) | 0.005* |
+ Significant when adjusted for clinical exposure. |
*Significant when adjusted for gender. |
When adjusted for clinical experience, female students were more likely to report gains in the area of participation in community affairs and taking action. When adjusted for gender, students in the clinical phase of their training were more likely to report gains in their clinical diagnostic skills and application of knowledge and skills learned during the training session and the ability to comprehend the moral and ethical issues in healthcare.
Secondary School Students
Most SS students felt that TriGen was beneficial across all nine FIPSE domains (Table 8). When adjusted for age, females were more likely to report gains in respect different opinion, compromise. When adjusted for gender, older students were more likely to report gains in appreciate teamwork and cooperation among peers, appreciate and identify gaps or deficiency in the healthcare system and enhance understanding of use of public health measures in resource poor setting.
Table 8
FIPSE in Secondary School Students
Domains of learning—“I feel that TriGen has helped me” | Total no. (%) | Female students, no.(%), n = 98 | Male students, no. (%), n = 65 | Males versus females | 14 and younger, no. (%), n = 28 | 15 and older, no. (%), n = 135 | 15 and older versus 14 and younger |
Pearson Chi-Square | Unadjusted odds ratio (OR) (95% confidence interval) | P value | Pearson Chi-Square | Unadjusted odds ratio (OR) (95% confidence interval) | P value |
Leadership Skills |
Feel responsible for others in the Community | 155 (95.1) | 94 (95.9) | 61 (93.8) | 0.36 | 0.649 (0.156–2.692) | 0.55 | 27 (96.4) | 128 (94.8) | 0.129 | 0.677 (0.080–5.733) | 0.72 |
Improve my leadership skills | 136 (83.4) | 81 (82.7) | 55 (84.6) | 0.109 | 1.154 (0.492–2.708) | 0.74 | 23 (82.1) | 113 (83.7) | 0.041 | 1.117 (0.383–3.254) | 0.84 |
Communication Skills |
Participate in community affairs | 145 (89.0) | 86 (87.8) | 59 (90.8) | 0.361 | 1.372 (0.488–3.861) | 0.55 | 23 (82.1) | 122 (90.4) | 1.598 | 2.040 (0.663–6.275) | 0.21 |
Develop communication, listening and negotiation skills | 155 (95.1) | 95 (96.9) | 60 (92.3) | 1.796 | 0.379 (0.087–1.644) | 0.18 | 25 (89.3) | 130 (96.3) | 2.442 | 3.120 (0.700-13.899) | 0.12 |
Teamwork |
Think of others | 156 (95.7) | 95 (96.9) | 61 (93.8) | 0.909 | 0.482 (0.104–2.226) | 0.34 | 27 (96.4) | 129 (95.6) | 0.043 | 0.796 (0.092–6.886) | 0.84 |
Appreciate teamwork and cooperation among peers | 158 (96.9) | 95 (96.9) | 63 (96.9) | 0.001 | 0.995 (0.162–6.123) | 1.0 | 25 (89.3) | 133 (98.5) | 6.648 | 7.980 (1.268–50.221) | 0.01* |
Be tolerant of different people | 159 (97.5) | 95 (96.9) | 64 (98.5) | 0.379 | 2.021 (0.206–19.863) | 0.54 | 27 (96.4) | 132 (97.8) | 0.176 | 1.630 (0.163–16.266) | 0.68 |
Respect different opinions | 156 (95.7) | 97 (99.0) | 59 (90.8) | 6.41 | 0.101 (0.012–0.863) | 0.011+ | 27 (96.4) | 129 (95.6) | 0.043 | 0.796 (0.092–6.886) | 0.84 |
Compromise | 151 (92.6) | 95 (96.9) | 56 (86.2) | 6.665 | 0.196 (0.051–0.756) | 0.01+ | 24 (85.7) | 127 (94.1) | 2.376 | 2.646 (0.738–9.488) | 0.12 |
Comprehend the moral and ethical issues in health care | 149 (91.4) | 88 (89.8) | 61 (93.8) | 0.817 | 1.733 (0.520–5.780) | 0.376 | 24 (85.7) | 125 (92.6) | 1.397 | 2.083 (0.603–7.193) | 0.24 |
Ability to see consequences |
Think about the future | 145 (89.0) | 89 (90.8) | 56 (86.2) | 0.865 | 0.629 (0.236–1.681) | 0.35 | 24 (85.7) | 121 (89.6) | 0.362 | 1.440 (0.436–4.756) | 0.55 |
Critical thinking skills |
Think critically | 142 (87.1) | 87 (88.8) | 55 (84.6) | 0.603 | 0.695 (0.277–1.746) | 0.44 | 24 (85.7) | 118 (87.4) | 0.059 | 1.157 (0.358–3.743) | 0.81 |
Ability to identify social issues |
Identify social issues and concerns | 151 (92.6) | 94 (95.9) | 57 (87.7) | 3.878 | 0.303 (0.087–1.052) | 0.049 | 24 (85.7) | 127 (94.1) | 2.376 | 2.646 (0.738–9.488) | 0.12 |
Action skills |
Take action | 148 (90.8) | 90 (91.8) | 58 (89.2) | 0.318 | 0.737 (0.253–2.140) | 0.57 | 24 (85.7) | 124 (91.9) | 1.045 | 1.879 (0.552–6.396) | 0.31 |
Build confidence & take on new responsibilities | 147 (90.2) | 91 (92.9) | 56 (86.2) | 1.984 | 0.479 (0.169–1.357) | 0.16 | 24 (85.7) | 123 (91.1) | 0.763 | 1.708 (0.508–5.747) | 0.38 |
Gaining of knowledge |
Appreciate and identify gaps or deficiencies in the healthcare system | 151 (92.6) | 93 (94.9) | 58 (89.2) | 1.84 | 0.445 (0.135–1.470) | 0.18 | 22 (78.6) | 129 (95.6) | 9.809 | 5.864 (1.734–19.833) | 0.002* |
Appreciate my own health, living condition | 158 (96.9) | 97 (99.0) | 61 (93.8) | 3.464 | 0.157 (0.017–1.440) | 0.063 | 27 (96.4) | 131 (97.0) | 0.029 | 1.213 (0.130-11.282) | 0.87 |
Improve my general knowledge about healthcare | 153 (93.9) | 92 (93.9) | 61 (93.8) | 0.001 | 0.995 (0.269–3.671) | 0.99 | 25 (89.3) | 128 (94.8) | 1.231 | 2.194 (0.531–9.067) | 0.27 |
Enhance my understanding of the use of public health measures in resource poor setting | 147 (90.2) | 92 (93.9) | 55 (84.6) | 3.787 | 0.359 (0.124–1.041) | 0.052 | 22 (78.6) | 125 (92.6) | 5.15 | 3.409 (1.125–10.333) | 0.023* |
Application of knowledge |
Improve my caregiving skills (e.g. blood pressure measurement, capillary blood glucose measurement) | 149 (91.4) | 90 (91.8) | 59 (90.8) | 0.057 | 0.874 (0.289–2.648) | 0.81 | 24 (85.7) | 125 (92.6) | 1.397 | 2.083 (0.603–7.193) | 0.24 |
Apply what I learnt in the training sessions (the one organized before the start of the home visits) | 138 (84.7) | 80 (81.6) | 58 (89.2) | 1.737 | 1.864 (0.731–4.754) | 0.19 | 22 (78.6) | 116 (85.9) | 0.966 | 1.665 (0.598–4.640) | 0.33 |
+ Significant when adjusted for age. |
*Significant when adjusted for gender. |
Program feedback
Healthcare undergraduates
Majority of the healthcare undergraduates felt more prepared for their practice as healthcare professionals in the future. 92.4% are now more aware of the problems faced by the older persons. 91.9% would recommend the program to their friends. (Table 9)
Table 9
| % of healthcare undergraduates who agreed (n = 185 unless otherwise stated) (95% CI) | % of students who agreed (n = 172) (95% CI) |
The multi-disciplinary meetings were useful for learning | 72.8 (65.7–79.9) (n = 169) | |
I am more prepared for my practice as a healthcare professional in the future. | 80.5 (74.6–85.9) | |
I am inspired and empowered to start something new to fulfill a social need | 75.1 (68.1–80.5) | |
I have achieved my personal goals set at the start of the cycle | 76.2 (69.7–82.2) | |
I better appreciate the importance of inter-professional collaboration in the care of patients | 91.6 (86.3–96.8) (n = 95) | |
I am now more confident with communicating with the elderly. | | 62.2 (55.2–69.8) |
The lessons learnt during the home visits are applicable to me and my family | | 75.0 (68.0-81.4) |
I will bring back the lessons learnt and educate my family members regarding the importance of healthy lifestyle and health screening | | 64.0 (56.4–71.5) |
The curriculum is useful for my learning | | 64.0 (57.0-71.5) |
I am now more confident in providing basic caregiving skills | 90.3 (85.9–94.1) | 65.7 (58.7–72.7) |
I am now more aware of the problems faced by the elderly | 92.4 (88.6–96.2) | 83.1 (77.9–88.4) |
I would recommend TriGen to my friends | 91.9 (87.6–95.7) | 91.3 (86.6–95.3) |
Secondary School Students
83.1% of SS students are more aware of problems faced by the older persons and 91.3% would recommend the program to their friends. (Table 9)
Patients’ outcomes
Table 10 describes the demographic of our patients. There were 116 patients who participated in the program. The mean age is 73.5 years-old. The mean age-adjusted Charlson co-morbidity index is 9.1.
Table 10
Demographic | Variables | Numbers (Percentages) |
Age | Mean 73.5 (54–95 years) | |
Gender | Males | 58 (54.7) |
Female | 48 (45.3) |
Race | Chinese | 71 (67.0) |
Malay | 6 (5.7) |
Indian | 26 (24.5) |
Others | 3 (2.8) |
Charlson Comorbidities Index | Mean 9.1 (SD 2.9) | |
Lawton IADL | Mean 4.4 (SD 2.4) | |
Alone | Yes | 12 (19.0) |
No | 51 (81.0) |
Housing | 1-room | 13 (21.0) |
2-room | 4 (6.5) |
3-room | 22 (35.5) |
4-room | 18 (29.0) |
5-room | 4 (6.5) |
Others | 1 (1.6) |
Financial | Yes | 40 (39.2) |
No | 62 (60.8) |
Carer | Self | 27 (42.9) |
Spouse | 8 (12.7) |
Children | 26 (41.3) |
Grandchildren | 1 (1.6) |
Siblings | 1 (1.6) |
A Wilcoxon signed-rank test showed a statistically significant decrease in hospital admission rates during the 6 months period before the program and the 6 months period after from a median of 1 visit to 0 visit. (Z = 2.72, p = 0.006). A Wilcoxon signed-rank test showed a statistically significant decrease in emergency department visits during the 6 months period before the program and 6 months period after from a median of 1 visit to 1 visit. (Z = 2.91, p = 0.004)
A total of 51 patients answered the patient feedback survey. The majority (> 80%) felt less lonely and happier because of the home visits. Most (> 50%) felt that they have changed their lifestyle for the better and feel more confident taking care of their own health as a result of the home visit. (Table 11)
Table 11
Because of the home visits, I .. | Agree (% of respondents) | Neutral | Disagree | Did not answer (% of all patients) |
I understand more about my health problems because of the home visits | 35 (71.4) | 8 (16.3) | 6 (12.2) | 57 (53.8) |
I feel more confident in taking care of my own health because of the home visits | 34 (68.0) | 12 (24.0) | 4 (8.0) | 56 (52.8) |
I have changed my lifestyle (e.g. diet, exercise, leaving the house more often, etc.) | 25 (50.0) | 13 (26.0) | 12 (24.0) | 56 (52.8) |
I want to continue to improve my health because of the home visits | 30 (61.2) | 11 (22.4) | 8 (16.3) | 57 (53.8) |
I feel less afraid to ask questions about my health because of the home visits | 26 (53.1) | 12 (24.5) | 11 (22.4) | 57 (53.8) |
I enjoyed the activities done during the home visits | 48 (96.0) | 2 (4.0) | 0 (0.0) | 56 (52.8) |
I feel less lonely because of the home visits | 42 (84.0) | 6 (12.0) | 2 (4.0) | 56 (52.8) |
I feel happier because of the home visits | 48 (94.1) | 3 (5.9) | | 55 (51.9) |
I look forward to the home visits | 44 (86.3) | 6 (11.8) | 1 (2.0) | 55 (51.9) |
I would like to continue the home visits with a different group of students | 32 (65.3) | 10 (20.4) | 7 (14.3) | 57 (53.8) |
The students were respectful | 49 (96.1) | 2 (3.9) | 0 (0.0) | 55 (51.9) |
I found it easy to talk to the students | 42 (82.4) | 8 (15.7) | 1 (2.0) | 55 (51.9) |
I made friends with the students | 37 (72.5) | 12 (23.5) | 2 (3.9) | 55 (51.9) |
My family/caregivers enjoy the home visits | 26 (70.3) | 10 (27.0) | 1 (2.7) | 69 (65.1) |
My family/caregivers are engaged by the team leaders and students during the home visits | 23 (69.7) | 9 (27.3) | 1 (3.0) | 73 (68.9) |
It was easy to schedule each home visit | 40 (78.4) | 8 (15.7) | 3 (5.9) | 55 (51.9) |
| Just nice | Too short / Too infrequent | Too long / Too frequent | Missing |
The duration of home visits is | 45 (88.2) | 5 (9.8) | 1 (2.0) | 55 (51.9) |
The frequent of the home visits is | 43 (86.0) | 7 (14.0) | 0 (0.0) | 56 (52.8) |
The number of students per visit is | 51 (100.0) | 0 (0.0) | 0 (0.0) | 55 (51.9) |